Study on the value of combining intravoxel incoherent motion with apparent diffusion coefficient in the diagnosis of prostate cancer
Objective:To explore the diagnostic value of combining quantitative parameters of intravoxel incoherent motion (IVIM) with apparent diffusion coefficient (ADC) for prostate cancer (PCa). Materials and Methods:Seventy-four cases underwent multiparametric magnetic resonance (mpMRI) prostate examination,including 41 cases of PCa (28 cases in the peripheral zone,13 cases in the transitional zone) and 33 cases of benign prostatic hyperplasia (BPH). Quantitative parameters including true diffusion coefficient (D),pseudo-diffusion coefficient (D ),perfusion fraction (f),and ADC value were obtained by using a bi-exponential model fitting algorithm. The differences in D value,D value,f value and ADC value were compared between PCa and prostate hyperplastic nodule with hypointense and hyperintense in T2WI. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of combining IVIM quantitative parameters with ADC for PCa. The correlation of each quantitative parameter of IVIM and ADC with the Gleason score was analyzed. Results:The ADC,D,and f values of PCa were significantly lower than those of hyperplastic nodule with hypointense and hyperintense in T2WI,with statistically significant differences (P<0.05). D value had the largest area under the curve (AUC) and the highest specificity in distinguishing PCa from prostate hyperplastic nodule with hypointense in T2WI,with statistically significant differences (P<0.05). The combination of ADC,D and f values significantly increased the AUC and sensitivity between PCa and hyperplastic nodule with hypointense in T2WI (0.948,90.24％ respectively). ADC value showed very high AUC,sensitivity and specificity for distinguishing PCa from prostate hyperplastic nodule with hyperintense in T2WI (0.997,97.65％,100.00％ respectively). There was no significant correlation between ADC value,each quantitative parameter of IVIM and the Gleason score (P=0.068,0.455,0.822,0.297). Conclusions:The quantitative parameters of IVIM combined with ADC can obviously improve the differential diagnostic efficacy for PCa and BPH.
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